Posts Tagged ‘addictions’

ScienceDaily (Mar. 8, 2012) — A single injection of cocaine or methamphetamine in mice caused their brains to put the brakes on neurons that generate sensations of pleasure, and these cellular changes lasted for at least a week, according to research by scientists at the Salk Institute for Biological Studies.

Their findings, reported March 7, 2012 in Neuron, suggest this powerful reaction to the drug assault may be a protective, anti-addiction response. The scientists theorize that it might be possible to mimic this response to treat addiction to these drugs and perhaps others, although more experiments are required to explore this possibility.

“It was stunning to discover that one exposure to these drugs could promote such a strong response that lasts well after the drug has left the body,” says Paul Slesinger, an associate professor in the Clayton Foundation Laboratories for Peptide Biology. “We believe this could be the brain’s immediate response to counteract the stimulation of these drugs.”

Scientists are trying to better understand the brain’s response to psychoactive drugs in hopes of finding new ways to prevent and treat addiction. This research has become especially important as the number of deaths due to drug abuse now exceeds those due to car accidents, with more than 37,000 people dying from drugs in 2009, according to the Centers for Disease Control and Prevention. Slesinger and Christian Lüscher, a long-time collaborator at the University of Geneva, have been investigating the cellular changes in the brain that occur with drug abuse.

Dopamine is a primary neurotransmitter used in the brain’s reward pathway — generally speaking, the activity of dopamine neurons in the reward pathway increases in response to rewards, such as sex, food and drugs. Psychostimulants, such as methamphetamine and cocaine, co-opt this pathway and alter the brain’s response to dopamine. Understanding the neuroadaptations that occur in the reward pathway in response to drugs of abuse may lead to the development of a treatment for drug addiction.

Previous research has shown that use of cocaine and methamphetamine in mice enhances excitatory connections to dopamine neurons. While most research has focused on these excitatory neurons, Slesinger and his colleagues looked at neurons that inhibit dopamine transmission, and found that one injection of cocaine or methamphetamine produces a profound change in the function of these inhibitory GABA neurons. These neurons were not able to control how they fired, so they would release more than the usual amount of inhibitory neurotransmitter.

“This persistent change in the inhibitory neurons occurs simultaneously with enhancement of excitatory inputs, indicating a possible compensatory mechanism that could be protective during exposure to drugs,” Slesinger says.

The Salk researchers identified a change in the biochemical pathway in inhibitory GABA neurons that led to this protective effect. It involved a change in the activity of a protein, known as a phosphatase, which controls the levels of a receptor known to be important for controlling the electrical activity of the GABA neuron.

“This particular pathway — involving a GABA type B receptor and a particular type of potassium channel — was affected by psychostimulants in these inhibitory neurons,” Slesinger says. “We noticed a dramatic reduction in the strength of this signaling pathway, which we showed was due to a decrease in the activity of the GABAB receptor and the potassium channel on the neuron’s membrane surface.”

“If we could tap into this pathway — enhance the ability of inhibitory neurons to control the activity of dopamine neurons — we might be able to treat some types of drug addiction,” Slesinger says.

What is not known is how long the drug response lasts — this study only looked at the brains of mice at two time points, 24 hours and seven days, after drug use — and why addiction ultimately develops with chronic drug use. These are questions Slesinger and his colleagues are now investigating.

The study’s two lead authors are Claire Padgett, a former postdoctoral researcher in the Slesinger laboratory, and Arnaud Lalive, a doctoral student at the University of Geneva, who is working in the laboratory of Christian Lüscher, also a co-author. Other participating investigators include: Michaelanne Munoz, of the University of California San Diego; Stephen Moss and colleagues from Tufts University School of Medicine; Rafael Luján, from the Universidad de Castilla-La Mancha in Albacete, Spain; and investigators from Hokkaido University School of Medicine in Sapporo, Japan; University College in London; and AstraZeneca in Cheshire, United Kingdom.

The study was funded by the National Institute on Drug Abuse, the National Institute of Neurological Disorders and Stroke, Catharina Foundation and the Spanish Ministry of Education and Science.

Like this:

ScienceDaily (July 2, 2012) — Researchers are closer to understanding the biology behind GHB, a transmitter substance in the brain, best known in its synthetic form as the illegal drug fantasy.

In the 1960s, gamma-hydroxybutyric acid (GHB) was first discovered as a naturally occurring substance in the brain. Since then it has been manufactured as a drug with a clinical application and has also developed a reputation as the illegal drug fantasy and as a date rape drug. Its physiological function is still unknown.

Now a team of researchers at the Department of Drug Design and Pharmacology at the University of Copenhagen has shown for the first time exactly where the transmitter substance binds in the brain under physiologically relevant conditions. The results have recently been published in the Proceedings of the National Academy of Sciences.

“We have discovered that GHB binds to a special protein in the brain — more specifically a GABAA-receptor. The binding is strong even at very low dosage. This suggests that we have found the natural receptor, which opens new and exciting research opportunities, in that we have identified an important unknown that can provide the basis for a full explanation of the biological significance of the transmitter,” says Laura Friis Eghorn, PhD student.

Illegal use and possible antidote

Fantasy is also used as a so-called date rape drug, because in moderate amounts it has sedative, sexually stimulating and soporific effects. The compound is also abused for its euphoric effect, but in combination with alcohol, for example, it is a deadly cocktail that can lead to a state of deep unconsciousness or coma.

“GHB is registered for use as a drug to treat alcoholism and certain types of sleep disorders, but the risk of abuse presents difficulties. In the long-term, understanding how GHB works will enable us to develop new and better pharmaceuticals with a targeted effect in the brain, without the dangerous side-effects of fantasy,” explains Laura Friis Eghorn, Department of Drug Design and Pharmacology.

Fantasy is an extremely toxic euphoriant, because the difference between a normal intoxicating dose and a fatal dose is so small. A better understanding of the biological mechanisms behind GHB-binding in the brain will benefit research into a life-saving antidote for this drug. Today there is no known antidote.

Statistics from Denmark in 2010 show that 8-10 percent of young people who frequent night clubs have had experience with Fantasy. However, since the drug is often also used in private for its sedative effect, it is difficult to estimate the extent of abuse.

Researchers on a targeted fishing expedition

The new research findings are the result of a collaboration between researchers at the University of Sydney in Australia and medicinal chemists at the Faculty of Health and Medical Sciences:

“Our chemist colleagues designed and produced special ligands — that are mimics of GHB in several variations. This enabled us to go on a targeted fishing expedition in the brain. We have slowly found our way to the receptor, which we have also been able to test pharmacologically. In itself, it is not unusual to find new receptors in the brain for known compounds. However, when we find a natural match rooted in the brain’s transmitter system, the biological implications are extremely interesting,” explains Petrine Wellendorph, associate professor and head of the responsible research group that produced the pioneering results.

Like this:

ScienceDaily (June 11, 2012) — Non-medical prescription drug use by college students is a growing trend on most campuses, according to the U.S. Department of Education’s Higher Education Center for Alcohol, Drug Abuse and Violence Prevention. Due to this trend, Western Illinois University Department of Health Sciences Assistant Professor Amanda Divin and her colleague, Keith Zullig, an associate professor in the West Virginia University School of Public Health, recently conducted and published a study that explores non-medical prescription drug use and depressive symptoms in college students.

Divin and Zullig utilized data from the fall 2008 American College Health Association National College Health Assessment (ACHA-NCHA), a national research survey that addresses seven areas of health and behavior of college students, one of which is alcohol, tobacco and other drug use. The sample used for the study (from the ACHA-NCHA data) contained 26,600 randomly selected college students from 40 campuses in the U.S. The student respondents were asked about their non-medical prescription drug use (including painkillers, stimulants, sedatives and antidepressants) and mental health symptoms within the last year.

According to Divin’s and Zullig’s results, approximately 13 percent of the college-student respondents reported non-medical prescription drug use, with those who reported feeling hopeless, sad, depressed or considered suicide being significantly more likely to report non-medical use of any prescription drug. The results also showed this relationship was more pronounced for females who reported painkiller use. The study — which is titled, “The association between non-medical prescription drug use, depressive symptoms, and suicidality among college students” — will appear in the August 2012 issue of Addictive Behaviors: An International Journal.

“Because prescription drugs are tested by the U.S. Food and Drug Administration and prescribed by a doctor, most people perceive them as ‘safe’ and don’t see the harm in sharing with friends or family if they have a few extra pills left over,” Divin explained. “Unfortunately, all drugs potentially have dangerous side effects. As our study demonstrates, use of prescription drugs — particularly painkillers like Vicodin and Oxycontin — is related to depressive symptoms and suicidal thoughts and behaviors in college students. This is why use of such drugs need to be monitored by a doctor and why mental health outreach on college campuses is particularly important.”

Divin and Zullig believe the results suggest that students are self-medicating their psychological distress with prescription medications.

“Considering how common prescription sharing is on college campuses and the prevalence of mental health issues during the college years, more investigation in this area is definitely warranted,” Divin added. “Our study is just one of the many first steps in exploring the relationship between non-medical prescription drug use and mental health.”

Like this:

ScienceDaily (June 20, 2012) — Thanks to modern science, we know that love lives in the brain, not in the heart. But where in the brain is it — and is it in the same place as sexual desire? A recent international study published in the Journal of Sexual Medicine is the first to draw an exact map of these intimately linked feelings.

“No one has ever put these two together to see the patterns of activation,” says Jim Pfaus, professor of psychology at Concordia University, member of the Center for Studies in Behavioral Neurobiology and a co-author of the study. “We didn’t know what to expect — the two could have ended up being completely separate. It turns out that love and desire activate specific but related areas in the brain.”

Along with colleagues in the U.S. and Switzerland, Pfaus analyzed the results from 20 separate studies that examined brain activity while subjects engaged in tasks such as viewing erotic pictures or looking at photographs of their significant others. By pooling this data, the scientists were able to form a complete map of love and desire in the brain.

They found that that two brain structures in particular, the insula and the striatum, are responsible for tracking the progression from sexual desire to love. The insula is a portion of the cerebral cortex folded deep within an area between the temporal lobe and the frontal lobe, while the striatum is located nearby, inside the forebrain.

Love and sexual desire activate different areas of the striatum. The area activated by sexual desire is usually activated by things that are inherently pleasurable, such as sex or food. The area activated by love is involved in the process of conditioning by which things paired with reward or pleasure are given inherent value. That is, as feelings of sexual desire develop into love, they are processed in a different place in the striatum.

Somewhat surprisingly, this area of the striatum is also the part of the brain that associated with drug addiction. Pfaus explains there is good reason for this. “Love is actually a habit that is formed from sexual desire as desire is rewarded. It works the same way in the brain as when people become addicted to drugs.”

ScienceDaily (June 1, 2012) — The U.S. had the second-lowest proportion of students who used tobacco and alcohol compared to their counterparts in 36 European countries, a new report indicates.

The results originate from coordinated school surveys about substance use from more than 100,000 students in some of the largest countries in Europe like Germany, France and Italy, as well as many smaller ones from both Eastern and Western Europe.

Because the methods and measures are largely modeled after the University of Michigan’s Monitoring the Future surveys in this country, comparisons are possible between the U.S. and European results. The 15- and 16-year-old students, who were drawn in nationally representative samples in almost all of the 36 countries, were surveyed last spring. American 10th graders in the 2011 Monitoring the Future studies are of the same age, so comparisons are possible.

The differences found between adolescent behaviors in the U.S. and Europe are dramatic, according to Lloyd Johnston, the principal investigator of the American surveys.

About 27 percent of American students drank alcohol during the 30 days prior to the survey. Only Iceland was lower at 17 percent, and the average rate in the 36 European countries was 57 percent, more than twice the rate in the U.S.

The proportion of American students smoking cigarettes in the month prior to the survey was 12 percent — again the second lowest in the rankings and again only Iceland had a lower rate at 10 percent. For all European countries the average proportion smoking was 28 percent, more than twice the rate in the U.S.

“One of the reasons that smoking and drinking rates among adolescents are so much lower here than in Europe is that both behaviors have been declining and have reached historically low levels in the U.S. over the 37-year life of the Monitoring the Future study,” Johnston said. “But even in the earlier years of the European surveys, drinking and smoking by American adolescents was quite low by comparison.

“Use of illicit drugs is quite a different matter.”

The U.S. students tend to have among the highest rates of use of all of the countries. At 18 percent, the U.S. ranks third of 37 countries on the proportion of students using marijuana or hashish in the prior 30 days. Only France and Monaco had higher rates at 24 percent and 21 percent, respectively. The average across all the European countries was 7 percent, or less than half the rate in the U.S.

American students reported the highest level of marijuana availability of all the countries and the lowest proportion of students associating great risk with its use — factors that may help to explain their relatively high rates of use here, according to Johnston.

The U.S. ranks first in the proportion of students using any illicit drug other than marijuana in their lifetime (16 percent compared to an average of 6 percent in Europe) and using hallucinogens like LSD in their lifetime (6 percent vs. 2 percent in Europe). It also ranks first in the proportion reporting ecstasy use in their lifetime (7 percent vs. 3 percent in Europe), despite a sharp drop in their ecstasy use over the previous decade. American students have the highest the proportion reporting lifetime use of amphetamines (9 percent), a rate that is three times the average in Europe (3 percent). Ecstasy was seen as more available in the U.S. than in any other country.

For some drugs, however, the lifetime prevalence rate in the U.S. was just about the average for the European countries, including inhalants (10 percent), cocaine (3 percent), crack (2 percent), heroin (1 percent) and anabolic steroids (1 percent).

“Clearly the U.S. has attained relatively low rates of use for cigarettes and alcohol, though not as low as we would like,” Johnston said. “But the level of illicit drug use by adolescents is still exceptional here.”

* * * This was the fifth coordinated data collection in Europe as part of the European School Survey Project on Alcohol and Other Drugs, the first being held in 1995 with 26 countries participating. The research plan this time was for each country to generate a representative national sample of 15- and 16-year-olds with at least 2,400 students being surveyed. All samples were nationally representative, except those in Germany, Russia, Flanders (the Dutch part of Belgium) and Bosnia-Herzegovina. In each of these cases a sub-national representative sample was surveyed, such as Moscow in the case of Russia.

The European survey group was led by Swedish sociologist Bjorn Hibbell, who has worked in the substance abuse field for many years. The American survey is led by social psychologist Lloyd Johnston, who has served as principal investigator of Monitoring the Future since its inception 37 years ago. MTF, which is conducted by the University of Michigan’s Institute for Social Research and is funded by the National Institute on Drug Abuse, had a sample of 15,400 10th-grade students in 126 high schools in the 2011 survey. Students completed confidential, self-administered questionnaires right in their classrooms in both the American and European surveys.

Like this:

ScienceDaily (June 4, 2012) — Treating adolescents for major depression can also reduce their chances of abusing drugs later on, a secondary benefit found in a five-year study of nearly 200 youths at 11 sites across the United States.

Only 10 percent of 192 adolescents whose depression receded after 12 weeks of treatment later abused drugs, compared to 25 percent of those for whom treatment did not work, according to research led by John Curry, a professor of psychology and neuroscience at Duke University.

“It turned out that whatever they responded to — cognitive behavioral therapy, Prozac, both treatments, or a placebo — if they did respond within 12 weeks they were less likely to develop a drug-use disorder,” Curry said.

The study found no such relationship when it came to thwarting alcohol abuse, however.

The researchers followed nearly half the 439 participants from the “Treatment for Adolescents with Depression Study” (TADS; 2000-2003), led by Dr. John March, chief of Child and Adolescent Psychiatry at Duke University Medical Center. TADS is considered the largest sample of adolescents who had been treated for major depression.

The participants analyzed by Curry’s study were ages 17-23 at the end of the five-year follow-up study and had no preexisting problems with abusing alcohol or drugs.

“Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression” (2004-2008), found that marijuana was the most prevalent drug used by study participants (76 percent); other drugs included cocaine, opiates and hallucinogens.

The adolescents must have had at least five symptoms for a length of time to be diagnosed with major depression prior to treatment: depressed mood; loss of interest; disruptions in appetite, sleep or energy; poor concentration; worthlessness; and suicidal thoughts or behavior.

The researchers said that improved mood regulation due to medicine or skills learned in cognitive-behavior therapy, along with support and education that came with all of the treatments, may have played key roles in keeping the youths off drugs.

The researchers were surprised to find no differences in alcohol abuse and do not have an answer for why. Curry thinks the prevalence of alcohol use among people ages 17-23 may be a key factor.

“It does point out that alcohol use disorders are very prevalent during that particular age period and there’s a need for a lot of prevention and education for college students to avoid getting into heavy drinking and then the beginnings of an alcohol disorder,” Curry said. “I think that is definitely a take-home message.”

Alcohol abuse also led to repeat bouts with depression for some participants, he said.

“When the teenagers got over the depression, about half of them stayed well for the whole five-year period, but almost half of them had a second episode of depression,” Curry said. “And what we found out was that, for those who had both alcohol disorder and another depression, the alcohol disorder almost always came first.”

Curry and co-author Susan Silva, associate professor and statistician in the Duke School of Nursing, believe more study is needed because the number of participants who developed drug or alcohol disorders was relatively small.

Also, there was no comparison group of non-depressed patients, so the researchers could not be sure that rates of subsequent drug and alcohol abuse disorders were higher than those for adolescents not treated for depression.

ScienceDaily (Jan. 27, 2011) — The growing numbers of new cases of substance abuse disorders are perplexing. After all, the course of drug addiction so often ends badly. The negative consequences of drug abuse appear regularly on TV, from stories of celebrities behaving in socially inappropriate and self-destructive ways while intoxicated to dramatization of the rigors of drug withdrawal on “Intervention” and other reality shows.

Schools now educate students about the risks of addiction. While having a keen awareness of the negative long-term repercussions of substance use protects some people from developing addictions, others remain vulnerable.

One reason that education alone cannot prevent substance abuse is that people who are vulnerable to developing substance abuse disorders tend to exhibit a trait called “delay discounting,” which is the tendency to devalue rewards and punishments that occur in the future. Delay discounting may be paralleled by “reward myopia,” a tendency to opt for immediately rewarding stimuli, like drugs.

Thus, people vulnerable to addiction who know that drugs are harmful in the long run tend to devalue this information and to instead be drawn to the immediately rewarding effects of drugs.

Delay discounting is a cognitive function that involves circuits including the frontal cortex. It builds upon working memory, the brain’s “scratchpad,” i.e., a system for temporarily storing and managing information reasoning to guide behavior.

In a new article in Biological Psychiatry that studied this process, Warren Bickel and colleagues used an approach borrowed from the rehabilitation of individuals who have suffered a stroke or a traumatic brain injury. They had stimulant abusers repeatedly perform a working memory task, “exercising” their brains in a way that promoted the functional enhancement of the underlying cognitive circuits.

They found that this type of training improved working memory and also reduced their discounting of delayed rewards.

“The legal punishments and medical damages associated with the consumption of drugs of abuse may be meaningless to the addict in the moment when they have to choose whether or not to take their drug. Their mind is filled with the imagination of the pleasure to follow,” commented Dr. John Krystal, Editor ofBiological Psychiatry. “We now see evidence that this myopic view of immediate pleasures and delayed punishments is not a fixed feature of addiction. Perhaps cognitive training is one tool that clinicians may employ to end the hijacking of imagination by drugs of abuse.”

Dr. Bickel agrees, adding that “although this research will need to be replicated and extended, we hope that it will provide a new target for treatment and a new method to intervene on the problem of addiction.”

ScienceDaily (June 2, 2008) — A study from the Massachusetts General Hospital (MGH) supports previous reports that adolescents with bipolar disorder are at increased risk for smoking and substance abuse. The article appearing in the June Drug and Alcohol Dependence — describing the largest such investigation to date and the first to include a control group — also indicates that bipolar-associated risk is independent of the risk conferred by other disorders affecting study participants.

“This work confirms that bipolar disorder (BPD) in adolescents is a huge risk factor for smoking and substance abuse, as big a risk factor as is juvenile delinquency,” says Timothy Wilens, MD, director of Substance Abuse Services in MGH Pediatric Psychopharmacology, who led the study. “It indicates both that young people with BPD need to carefully be screened for smoking and for substance use and abuse and that adolescents known to abuse drugs and alcohol — especially those who binge use — should also be assessed for BPD.”

It has been estimated that up to 20 percent of children and adolescents treated for psychiatric problems have bipolar disorder, and there is evidence that pediatric and adolescent BPD may have features, such as particularly frequent and dramatic mood swings, not found in the adult form of the disorder.

While elevated levels of smoking and substance abuse previously have been reported in young and adult BPD patients, it has not been clear how the use and abuse of substances relates to the presence of BPD or whether any increased risk could be attributed to co-existing conditions such as attention-deficit hyperactivity disorder (ADHD), conduct disorder or anxiety disorders.

The current study analyzes extensive data — including family histories, information from primary care physicians, and a detailed psychiatric interview — gathered at the outset of a continuing investigation following a group of young BPD patients into adulthood. In addition to 105 participants with diagnosed BPD, who enrolled at an average age of 14, the study includes 98 control participants of the same age, carefully screened to rule out mood disorders.

Incidence of each measure — alcohol abuse or dependence, drug abuse or dependence, and smoking — was significantly higher in participants with BPD than in the control group.

Overall, rates of substance use/abuse were 34 percent in the bipolar group and 4 percent in controls. When adjusted to account for co-occurring behavioral and psychiatric conditions, the results still indicated significantly higher risk in the bipolar group. Analyzing how the onset of bipolar symptoms related to when substance abuse began, revealed that BPD came first in most study participants.

The data also indicated that bipolar youth whose symptoms began in adolescence were more likely to abuse drugs and alcohol than were those whose symptoms began in childhood. “It could be that the onset of mood dysregulation in adolescence puts kids at even higher risk for poor judgement and self-medication of their symptoms,” Wilens says. “It also could be that some genetic switch activated in adolescence turns on both BPD and substance abuse in these youngsters. That’s something that we are currently investigating in genetic and neuroimaging studies of this group.”

He adds that clarifying whether bipolar disorder begins before substance abuse starts could have “a huge impact. If BPD usually precedes substance abuse, there may be intervention points where we could reduce its influence on drug and alcohol abuse.

Aggressive treatment of BPD could cut the risk of substance abuse, just as we have shown it does in ADHD.” Wilens is an associate professor of Psychiatry at Harvard Medical School.

The National Institute of Mental Health is supporting the long-term study of bipolar youth of which this report is one phase. Co-authors of the Drug and Alcohol Dependence article are Joseph Biederman, MD, Joel Adamson, Aude Henin, Stephanie Sgambati, Robert Sawtelle, Alison Santry and Michael Monuteaux, ScD, MGH Pediatric Psychopharmacology; and Martin Gignac, MD, University of Montreal.

Many of us are used to thinking of DNA as this unchanging programming that governs all our body’s responses for the rest of our lives. In essence, certain things about our DNA are unlikely to change, ever. But there are a number of outside things that could result in minor DNA change.

As we age, for instance, you may note DNA expression changes in a variety of ways. Hair gets gray, skin gets wrinkly, and diseases are more common. The effect of environmental influence on DNA is still being studied intensely, but there are some certain known features. For one thing, DNA change may really be better called DNA mutation. Certain cells programs don’t work as well, and this is reflected in aging. Exactly why certain codes, for example to produce tight young skin, don’t work as well isn’t fully known. There is strong supposition though that things like sun exposure may change how well DNA operates.

Similarly, DNA builds cancerous cells and this is accepted as mutation of DNA’s original intent. We aren’t supposed to have cancer. There are several factors at work here too. For some reason, the program of DNA misfires, resulting in producing abnormal cells. DNA may already influence how likely we are to have cancer, and environment may have effect on DNA resulting in production of cancerous cells.

Mutations or DNA change have also been noted with the introduction of certain viruses into the body. In fact this is a method by which “gene therapy” is being studied in depth. Scientists and medical researchers are using small virus cells, usually of common illnesses like colds, to change small parts of gene expression, since it is known that viruses may rewrite some of the DNA code.

By some of the code, it should be understood that DNA change is tiny and infinitesimal, governing very few expressions of certain genes. Most of your building block DNA does not undergo change, and is not likely to. There has been an upsurge of theory in alternative health and self help fields about how changing thinking might result in DNA change. This is unproven work, though there are some interesting changes that science has noted. One is a noted ability for people who have undergone trauma to evolve new neural pathways in the brain when undergoing therapy like cognitive behavioral therapy; yet this may simply be an expression of what your brain cells are already coded to do.

Another interesting field that relates to this subject is that of epigenetics, which evaluates how environmental influence may affect the DNA of your children. Previously, DNA code in reproductive cells was thought to be unchanged (expect by mutation). Now scientists are evaluating how the DNA encoded in reproductive cells may be changed by slight differences in the way people behave before they have children.

Your DNA may not just be a matter of inheriting family traits like hair or eye color or risk for certain diseases, but might also be influenced by how your parents behaved. Some influential factors include being overweight or smoking prior to conceiving children. This has led some to conclude that people who wait until they are older to have children may have significantly changed the DNA of their future children though life choices and environmental exposure.

ScienceDaily (May 16, 2012) — Genes play a greater role in forming character traits — such as self-control, decision making or sociability — than was previously thought, new research suggests.

A study of more than 800 sets of twins found that genetics were more influential in shaping key traits than a person’s home environment and surroundings.

Psychologists at the University of Edinburgh who carried out the study, say that genetically influenced characteristics could well be the key to how successful a person is in life.

The study of twins in the US — most aged 50 and over- used a series of questions to test how they perceived themselves and others. Questions included “Are you influenced by people with strong opinions?” and “Are you disappointed about your achievements in life?”

The results were then measured according to the Ryff Psychological Well-Being Scale which assesses and standardizes these characteristics.

By tracking their answers, the research team found that identical twins — whose DNA is [presumed to be] exactly the same — were twice as likely to share traits compared with non-identical twins.

Psychologists say the findings are significant because the stronger the genetic link, the more likely it is that these character traits are carried through a family.

Professor Timothy Bates, of the University of Edinburgh’s School of Philosophy, Psychology and Language Sciences, said that the genetic influence was strongest on a person’s sense of self-control.

Researchers found that genes affected a person’s sense of purpose, how well they get on with people and their ability to continue learning and developing.

Professor Bates added: “Ever since the ancient Greeks, people have debated the nature of a good life and the nature of a virtuous life. Why do some people seem to manage their lives, have good relationships and cooperate to achieve their goals while others do not? Previously, the role of family and the environment around the home often dominated people’s ideas about what affected psychological well-being. However, this work highlights a much more powerful influence from genetics.”

The study, which builds on previous research that found that happiness is underpinned by genes, is published online in theJournal of Personality.

ScienceDaily (June 15, 2011) — People seeking help for their alcohol or other drug problems enter treatment with very different levels of motivation to change. Differences in motivation appear to make a critical difference in which patients seek, comply with, and complete treatment. Findings from a study of the extent to which motivation and self-efficacy — the confidence to resist temptation and to abstain from drinking — changed during treatment, and the degree to which these variables affected drinking behaviors, indicate that treatments tailored to specific subgroups may be more effective.

Results will be published in the September 2011 issue ofAlcoholism: Clinical & Experimental Research and are currently available at Early View.

“There are a number of different ways to talk about motivation,” said J. Kim Penberthy, associate professor of psychiatry & neurobehavioral sciences at the University of Virginia School of Medicine as well as corresponding author for the study.

“We decided to focus on motivation in the form of stages of change and self-efficacy,” Penberthy explained. “The model we are using conceptualizes motivation as a level of readiness to change and self-efficacy as a combination of temptation to drink alcohol and confidence to abstain from drinking. For example, people who are in a stage such as action and maintenance have completed early tasks related to overcoming ambivalence, decision making, and commitment to a plan and are, therefore, more motivated to change their behavior by reducing drinking prior to treatment onset. Similarly, people who have developed a strong belief in their ability to resist temptations to drink are more confident and think about tempting situations differently, thereby increasing their motivation to not drink and not relapse.”

While the effects of patient motivation and self-efficacy on change has not been extensively studied in clinical pharmacobehavioral trials, she added, they are crucially important in terms of who responds to treatment and when, particularly over time.

Penberthy and her colleagues evaluated changes in motivation, temptation to drink, confidence to abstain, and drinking behaviors during the treatment phase of a pharmacobehavioral study of 321 (226 men, 95 women) alcohol-dependent individuals. Participants received cognitive behavioral therapy (CBT) and either ondansetron or a placebo. The researchers also examined the degree to which individual variables such as initial drinking severity, age of onset of alcohol dependence, and medication status influenced changes in motivation, self-efficacy, and drinking behaviors.

For example, an anti-craving medication called ondansetron was more effective in early-onset versus late-onset drinkers in reducing drinks per drinking day, increasing percent of days abstinent, as well as decreasing temptation to drink. However, ondansetron did not have a different impact on early- versus late-onset alcoholics in terms of increased motivation or confidence to abstain from drinking.

“It was also found that reductions in drinking behavior in early-onset drinkers may be mediated by reduced temptation to drink,” said Penberthy. “This supports the idea of early-onset alcoholism being a biologically based disease and more responsive to selective serotonergic agents to reduce temptation to drink, which in turn, leads to decreased drinking behavior.”

Penberthy added that clinicians and researchers need to focus their research and clinical work on tailoring treatment approaches to patients based upon the stage of their disease, the patient’s stage or level of motivation, their self-efficacy, and biological responsiveness to medications.

“The current research is a first step in understanding more about which alcohol-dependent individuals respond to treatment and what mechanisms may be involved in the changes in drinking and drinking-specific changes in frequency and intensity of drinking,” she said. “Such knowledge is needed in order to understand inconsistent results from prior pharmacobehavioral trials, and to tailor treatments more effectively to individuals. Additional research is needed to fully understand the interplay between medication, demographic variables, and psychological variables in treatment for alcohol dependence.”

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

Like this:

ScienceDaily (July 12, 2011) — Research to be presented at the upcoming annual meeting of the Society for the Study of Ingestive Behavior (SSIB), the foremost society for research into all aspects of eating and drinking behavior, suggests that people can become dependent on highly palatable foods and engage in a compulsive pattern of consumption, similar to the behaviors we observe in drug addicts and those with alcoholism.

Using a questionnaire originally developed by researchers at Yale University, a group of obese men and women were assessed according to the 7 symptoms recommended by the American Psychiatric Association to diagnose substance dependence (e.g., withdrawal, tolerance, continued use despite problems), with questions modified by replacing the word food for drugswithin the questions. Based on their responses, individuals were classified as ‘food addicts’ or non-addicts, and then the two groups were compared in three areas relevant to conventional addiction disorders: clinical co-morbidities, psychological risk factors, and abnormal motivation for the addictive substance.

While ‘food addicts’ did not differ from non-addicts in their age or body weight (controlled for height), they displayed an increased prevalence of binge-eating disorder and depression, and more symptoms of attention-deficit/hyperactivity disorder. They also were characterized by more impulsive personality traits, were more sensitive or responsive to the pleasurable properties of palatable foods, and were more likely to ‘self-soothe’ with food.

“These results strongly reinforce the view that food addiction is an identifiable condition with clinical symptoms, and is characterized by a psycho-behavioral profile that is similar to conventional drug-abuse disorders,” said Dr. Davis. “The results also deliver much needed human support for the growing evidence of sugar and fat addiction in experimental animal research,” she added. “These findings advance our search for clinically relevant subtypes of obesity that may possess different biological and psychological vulnerabilities to environmental risk factors. This type of information will help us develop personalized treatment approaches for those who struggle with overeating and escalating weight gain.”

Like this:

ScienceDaily (Dec. 10, 2008) — A Princeton University scientist will present new evidence today demonstrating that sugar can be an addictive substance, wielding its power over the brains of lab animals in a manner similar to many drugs of abuse.

Professor Bart Hoebel and his team in the Department of Psychology and the Princeton Neuroscience Institute have been studying signs of sugar addiction in rats for years. Until now, the rats under study have met two of the three elements of addiction. They have demonstrated a behavioral pattern of increased intake and then showed signs of withdrawal. His current experiments captured craving and relapse to complete the picture.

“If bingeing on sugar is really a form of addiction, there should be long-lasting effects in the brains of sugar addicts,” Hoebel said. “Craving and relapse are critical components of addiction, and we have been able to demonstrate these behaviors in sugar-bingeing rats in a number of ways.”

At the annual meeting of the American College of Neuropsychopharmacology in Scottsdale, Ariz., Hoebel will report on profound behavioral changes in rats that, through experimental conditions, have been trained to become dependent on high doses of sugar.

“We have the first set of comprehensive studies showing the strong suggestion of sugar addiction in rats and a mechanism that might underlie it,” Hoebel said. The findings eventually could have implications for the treatment of humans with eating disorders, he said.

Lab animals, in Hoebel’s experiments, that were denied sugar for a prolonged period after learning to binge worked harder to get it when it was reintroduced to them. They consumed more sugar than they ever had before, suggesting craving and relapse behavior. Their motivation for sugar had grown. “In this case, abstinence makes the heart grow fonder,” Hoebel said.

The rats drank more alcohol than normal after their sugar supply was cut off, showing that the bingeing behavior had forged changes in brain function. These functions served as “gateways” to other paths of destructive behavior, such as increased alcohol intake. And, after receiving a dose of amphetamine normally so minimal it has no effect, they became significantly hyperactive. The increased sensitivity to the psychostimulant is a long-lasting brain effect that can be a component of addiction, Hoebel said.

The data to be presented by Hoebel is contained in a research paper that has been submitted to The Journal of Nutrition. Visiting researchers Nicole Avena, who earned her Ph.D. from Princeton in 2006, and Pedro Rada from the University of Los Andes in Venezuela wrote the paper with Hoebel.

Hoebel has been interested in the brain mechanisms that control appetite and body weight since he was an undergraduate at Harvard University studying with the renowned behaviorist B.F. Skinner. On the Princeton faculty since 1963, he has pioneered studies into the mental rewards of eating. Over the past decade, Hoebel has led work that has now completed an animal model of sugar addiction.

Hoebel has shown that rats eating large amounts of sugar when hungry, a phenomenon he describes as sugar-bingeing, undergo neurochemical changes in the brain that appear to mimic those produced by substances of abuse, including cocaine, morphine and nicotine. Sugar induces behavioral changes, too. “In certain models, sugar-bingeing causes long-lasting effects in the brain and increases the inclination to take other drugs of abuse, such as alcohol,” Hoebel said.

Hoebel and his team also have found that a chemical known as dopamine is released in a region of the brain known as the nucleus accumbens when hungry rats drink a sugar solution. This chemical signal is thought to trigger motivation and, eventually with repetition, addiction.

The researchers conducted the studies by restricting rats of their food while the rats slept and for four hours after waking. “It’s a little bit like missing breakfast,” Hoebel said. “As a result, they quickly eat some chow and drink a lot of sugar water.” And, he added, “That’s what is called binge eating — when you eat a lot all at once — in this case they are bingeing on a 10 percent sucrose solution, which is like a soft drink.”

Hungry rats that binge on sugar provoke a surge of dopamine in their brains. After a month, the structure of the brains of these rats adapts to increased dopamine levels, showing fewer of a certain type of dopamine receptor than they used to have and more opioid receptors. These dopamine and opioid systems are involved in motivation and reward, systems that control wanting and liking something. Similar changes also are seen in the brains of rats on cocaine and heroin.

In experiments, the researchers have been able to induce signs of withdrawal in the lab animals by taking away their sugar supply. The rats’ brain levels of dopamine dropped and, as a result, they exhibited anxiety as a sign of withdrawal. The rats’ teeth chattered, and the creatures were unwilling to venture forth into the open arm of their maze, preferring to stay in a tunnel area. Normally rats like to explore their environment, but the rats in sugar withdrawal were too anxious to explore.

The findings are exciting, Hoebel said, but more research is needed to understand the implications for people. The most obvious application for humans would be in the field of eating disorders.

“It seems possible that the brain adaptations and behavioral signs seen in rats may occur in some individuals with binge-eating disorder or bulimia,” Hoebel said. “Our work provides links between the traditionally defined substance-use disorders, such as drug addiction, and the development of abnormal desires for natural substances. This knowledge might help us to devise new ways of diagnosing and treating addictions in people.”

Like this:

ScienceDaily (Apr. 30, 2012) — Scientists at the Gladstone Institutes have determined how specific circuitry in the brain controls not only body movement but also motivation and learning, providing new insight into neurodegenerative disorders such as Parkinson’s disease — and psychiatric disorders such as addiction and depression.

Previously, researchers in the laboratory of Gladstone Investigator Anatol Kreitzer, PhD, discovered how an imbalance in the activity of a specific category of brain cells is linked to Parkinson’s. Now, in a paper published online April 29 inNature Neuroscience, Dr. Kreitzer and his team used animal models to demonstrate that this imbalance may also contribute to psychiatric disorders. These findings also help explain the wide range of Parkinson’s symptoms — and mark an important step in finding new treatments for those who suffer from addiction or depression. “The physical symptoms that affect people with Parkinson’s — including tremors and rigidity of movement — are caused by an imbalance between two types of medium spiny neurons in the brain,” said Dr. Kreitzer, whose lab studies how Parkinson’s disease affects brain functions. “In this paper we showed that psychiatric disorders — specifically addiction and depression — might be caused by this same neural imbalance.” Normally, two types of medium spiny neurons, or MSNs, coordinate body movements. One type, called direct pathway MSNs (dMSNs), acts like a gas pedal. The other type, known as indirect pathway MSNs (iMSNs), acts as a brake. And while researchers have long known about the link between a chemical in the brain called dopamine and Parkinson’s, Gladstone researchers recently clarified that dopamine maintains the balance between these two MSN types. But abnormal dopamine levels are implicated not only in Parkinson’s, but also in addiction and depression. Dr. Kreitzer and his team hypothesized that the same circuitry that controlled movement might also control the process of learning to repeat pleasurable experiences and avoid unpleasant ones — and that an imbalance in this process could lead to addictive or depressive behaviors. Dr. Kreitzer and his team genetically modified two sets of mice so that they could control which specific type of MSN was activated. They placed mice one at a time in a box with two triggers — one that delivered a laser pulse to stimulate the neurons and one that did nothing. They then monitored which trigger each mouse preferred. “The mice that had only dMSNs activated gravitated toward the laser trigger, pushing it again and again to get the stimulation — reminiscent of addictive behavior,” said Alexxai Kravitz, PhD, Gladstone postdoctoral fellow and a lead author of the paper. “But the mice that had only iMSNs activated did the opposite. Unlike their dMSN counterparts, the iMSN mice avoided the laser stimulation, which suggests that they found it unpleasant.” These findings reveal a precise relationship between the two MSN types and how behaviors are learned. They also show how an MSN imbalance can throw normal learning processes out of whack, potentially leading to addictive or depressive behavior. “People with Parkinson’s disease often show signs of depression before the onset of significant movement problems, so it’s likely that the neural imbalance in Parkinson’s is also responsible for some behavioral changes associated with the disease,” said Dr. Kreitzer, who is also an assistant professor of physiology at the University of California, San Francisco, with which Gladstone is affiliated. “Future research could discover how MSNs are activated in those suffering from addiction or depression — and whether tweaking them could reduce their symptoms and improve their quality of life. Graduate student Lynne Tye was also a lead author on this paper. Funding came from a variety of sources, including the W.M. Keck Foundation, the Pew Biomedical Scholars Program, the McKnight Foundation and the National Institutes of Health.

I am medical doctor and hypnotherapist with more than 17 years experience. Feel free to send me email (guide.rehab@gmail.com) to discuss your situation.

Whether our addictions have to do with alcohol, drugs, food, sex, gambling, emailing, or shopping, the addictive behavior is often preceded by some triggering event that sets off a flurry of uncomfortable thoughts, feelings, and sensations, leading to cravings and urges to engage in the addictive behavior. An important part of recovery is being able to recognize our triggers and how cravings and urges manifest in our bodies and minds. The practice of Mindfulness gives us a unique tool to slow time down and bring awareness to the thoughts, feelings, and sensations associated with the triggering event while it is occurring.

As soon as we bring awareness to the moment, we have stepped out of auto-pilot, giving the choice over our behavior back to us and in turn giving us the ability to gain back control of our behaviors and our lives. Often, cravings and urges are our longing for things to be different than the way they are in the moment. Dr. Alan Marlatt, the Director of the Addictive Behavior Research Center at the University of Washington, defines a craving as the desire to experience the effects of engaging in the addictive behavior, while an urge is a relatively sudden impulse to engage in an act such as drinking, shopping, or gambling – feeling the high.

Urges and cravings often feel like they strike without warning, but with a mindful lens, we can develop a sensitivity to the internal and external cues and an openness to the present-moment experience that counteracts our addictive behaviors. Dr. Marlatt proposes a few ways urges and cravings can be triggered. The first is through a lack of insight into the body-feeling state such as sadness, anxiety, or guilt that manifest as physical sensations in the body. The second is through defensive and distorted styles of thinking, such as denial, rumination, or catastrophizing. The third is through our automatic negative interpretations of events such as attributing a relapse to personal weakness. In practicing mindfulness, we are not trying to get rid of or avoid these difficult experiences, but instead instill an openness and curiosity about them, learning how to acknowledge them and relate to them differently, breaking the cycle of relapse. Take a moment right now to bring awareness to how your emotions, distorted thought styles, and automatic interpretations of events, can feed into cravings and urges.

In terms of emotions, a growing amount of research is pointing to an unquestionable connection between negative emotions and relapse. The internationally acclaimed Buddhist monk, Thich Nhat Hanh speaks to the importance of being aware of our difficult emotions and even approaching them with compassion rather than suppressing them. It is the natural course of emotions to come and go as it is for thoughts, physical sensations, and just about everything else. Think about if you have ever felt the emotion of sadness or joy. Did the feeling eventually pass? However, with uncomfortable emotions we often try to ignore or avoid them. It is in this struggling and avoidance where we find our greatest suffering and in turn, our greatest triggers, cravings, and urges. Mindfulness gives us the ability to become aware of our emotions and as soon as this happens, we move from auto-pilot to the present-moment and regain the ability to be in control. As we do this, we increase our awareness of the impermanence of emotions, reduce cravings and urges, and become less fearful and more confident that we can do it again the next time without resorting to addictive behavior.So what do we do, how can mindfulness help?

In concert with the fundamental principle of impermanence found in mindfulness literature, Dr. Marlatt developed a technique called “urge surfing” which uses mindfulness and breath-focused meditation to help us ride out the urge. An urge to engage in an addictive behavior can be seen as an ocean wave in that it starts small, gets bigger, crests, and finally subsides. Urge surfing teaches us to use the focus of our breath as a “surfboard” for riding the wave of uncomfortable thoughts, feelings, and sensations rather than struggling or giving in to it. Although ideally it is best to be guided through this, here are a few steps you can try to get started:

First do a brief practice where you sit, stand, or lie down and notice your breath coming in and out of your body. You can think of it as keeping your breath company. This is good initial practice so when an urge comes you’ll be more likely to remember to do this.

As you have the urge, you can bring awareness to the breath and let it surf the wave of the sensations associated with the urge. Noticing the physical sensation of the impulse as it changes and intensifies in the body. You may notice sweating, salivating, tightening of the muscles, or constriction of the chest.

Be aware of any thoughts that arise in the mind and also be aware how they come and go as well.

Many people can testify to the idea that an intense urge only lasts about 20-30 minutes, so notice the urge as it eventually falls like a wave in the ocean.

As I mentioned earlier, it helps to be guided by a live person or a CD, but this is a good start.

May you be well, may you be at peace, may you be healthy, may you be free from suffering!

Elisha Goldstein, Ph.D. is a pioneer in the integration of mindfulness meditative techniques into the clinical therapeutic setting. He holds a private practice is West Los Angeles, is a public speaker, and a Consultant to Aliveworld. He is author of the audio CD “Mindful Solutions for Stress, Anxiety, and Depression”, co-author of the CD “Mindful Solutions for Addiction and Relapse Prevention” (http://drsgoldstein.com/CDs.aspx), co-author of the upcoming workbook “Mindfulness Stress Reduction” and co-author of the multimedia Guide and Community “Mindfulness, Anxiety, and Stress” found in Aliveworld (http://www.aliveworld.com) He also teaches Mindfulness-Based Stress Reduction (MBSR).

ScienceDaily (Aug. 24, 2011) — It is well established that a mood disorder can increase an individual’s risk for substance abuse, but there is also evidence that the converse is true; substance abuse can increase a person’s vulnerability to stress-related illnesses. Now, a new study finds that repeated cocaine use increases the severity of depressive-like responses in a mouse model of depression and identifies a mechanism that underlies this cocaine-induced vulnerability.

The research, published by Cell Press in the August 25 issue of the journal Neuron, may guide development of new treatments for mood disorders associated with substance abuse.

“Clinical evidence shows that substance abuse can increase an individual’s risk for a mood disorder,” explains senior study author, Dr. Eric Nestler from Mount Sinai School of Medicine “However, although this is presumably mediated by drug-induced neural adaptations that alter subsequent responses to stress, the mechanisms underlying this phenomenon were largely unexplored.”

Dr. Nestler and colleagues examined whether histone H3 lysine 9 dimethylation (H3K9me2), a prominent type of chromatin modification, might be involved in the effects of repeated cocaine use on vulnerability to depressive-like behaviors. Histones are found in the nucleus where they package the DNA into chromatin, and changing the number of histone methyl groups can alter gene expression. A reduction in H3K9me2 reflects a decrease in the number of histone methyl groups, and previous human and animal studies have found a link between histone methylation and mood disorders.

The researchers found that cocaine increases the susceptibility of mice to stress in a well-established model of depression and that decreased H3K9me2 in the nucleus accumbens, a major reward center in the brain, was a central mechanism linking cocaine with stress vulnerability. Importantly, knockout of an enzyme called G9a that controls H3K9me2 in the nucleus accumbens was sufficient to enhance an animal’s vulnerability to stress, while excess G9a in the same region blocked the ability of cocaine to increase stress susceptibility.

The researchers went on to show that this G9a-mediated resilience to stress was mediated, in part, through repression of the BDNF-TrkB-CREB signaling pathway. This is significant because BDNF-TrkB-CREB signaling is increased in the nucleus accumbens by exposure to stress or cocaine and promotes both depressive and addictive behaviors. “Together, our results provide fundamentally novel insight into how prior exposure to a drug of abuse enhances vulnerability to depression and other stress-related disorders,” concludes Dr. Nestler. “Identifying such common regulatory mechanisms may aid in the development of new therapies for addiction and depression.”

ScienceDaily (Aug. 15, 2011) — The American Society of Addiction Medicine (ASAM) has released a new definition of addiction highlighting that addiction is a chronic brain disorder and not simply a behavioral problem involving too much alcohol, drugs, gambling or sex. This the first time ASAM has taken an official position that addiction is not solely related to problematic substance use.

When people see compulsive and damaging behaviors in friends or family members — or public figures such as celebrities or politicians — they often focus only on the substance use or behaviors as the problem. However, these outward behaviors are actually manifestations of an underlying disease that involves various areas of the brain, according to the new definition by ASAM, the nation’s largest professional society of physicians dedicated to treating and preventing addiction.

“At its core, addiction isn’t just a social problem or a moral problem or a criminal problem. It’s a brain problem whose behaviors manifest in all these other areas,” said Dr. Michael Miller, past president of ASAM who oversaw the development of the new definition. “Many behaviors driven by addiction are real problems and sometimes criminal acts. But the disease is about brains, not drugs. It’s about underlying neurology, not outward actions.”

The new definition resulted from an intensive, four-year process with more than 80 experts actively working on it, including top addiction authorities, addiction medicine clinicians and leading neuroscience researchers from across the country. The full governing board of ASAM and chapter presidents from many states took part, and there was extensive dialogue with the National Institute on Drug Abuse (NIDA).

The new definition also describes addiction as a primary disease, meaning that it’s not the result of other causes such as emotional or psychiatric problems. Addiction is also recognized as a chronic disease, like cardiovascular disease or diabetes, so it must be treated, managed and monitored over a life-time.

Two decades of advancements in neurosciences convinced ASAM that addiction needed to be redefined by what’s going on in the brain. Research shows that the disease of addiction affects neurotransmission and interactions within reward circuitry of the brain, leading to addictive behaviors that supplant healthy behaviors, while memories of previous experiences with food, sex, alcohol and other drugs trigger craving and renewal of addictive behaviors. Meanwhile, brain circuitry that governs impulse control and judgment is also altered in this disease, resulting in the dysfunctional pursuit of rewards such as alcohol and other drugs. This area of the brain is still developing during teen-age years, which may be why early exposure to alcohol and drugs is related to greater likelihood of addiction later in life.

There is longstanding controversy over whether people with addiction have choice over anti-social and dangerous behaviors, said Dr. Raju Hajela, past president of the Canadian Society of Addiction Medicine and chair of the ASAM committee on the new definition. He stated that “the disease creates distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

“Choice still plays an important role in getting help. While the neurobiology of choice may not be fully understood, a person with addiction must make choices for a healthier life in order to enter treatment and recovery. Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviors is necessary,” Hajela said.

“Many chronic diseases require behavioral choices, such as people with heart disease choosing to eat healthier or begin exercising, in addition to medical or surgical interventions,” said Dr. Miller. “So, we have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction, and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment.”

Share this:

Like this:

Bipolar disorder and addiction often go together. As many as 60 percent of people with bipolar disorder will have some form of substance abuse during their lifetime, and research is underway to better understand this “dual diagnosis” — the term used for the combination of addiction and a mental disorder. Both of these disorders tend to first emerge during the teenage years, says Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI), and studies have found that teens with bipolar disorder are more likely to experiment with drugs and alcohol.

Those with bipolar may turn to depressants — such as alcohol or pain pills — to try to manage their mania, or to stimulants — such as cocaine or methamphetamines — to cope withdepression. In both cases, the usual result is that the substance abuse kicks the bipolar disorder into the opposite state — depression or mania — rather than fixing anything. “Short term, drugs and alcohol do change how you feel,” notes Duckworth. “But long-term it tends to be very counterproductive.”

Bipolar and Addicted: One Woman’s Story

For Jacqueline Castine, alcohol was a part of life. While growing up, everyone in her family drank. So when she became an adult, her own drinking didn’t seem that out of the ordinary in comparison.

Castine recalls drinking heavily on a daily basis for years, all while being a self-described overachiever with a high-profile career, a “perfect family,” and the “perfect marriage.”

“I was a functional alcoholic, from a family of functional alcoholics,” she says. “We didn’t realize what we were really doing was self-medicating for a mood disorder.”

Castine followed her twin sister’s lead into the world of sobriety at the age of 48. Around the same time, she also divorced and left her high-profile corporate position. That’s when “the dragon I always kept on the back porch,” as she describes it, wouldn’t stay outside any longer.

For seven years, she struggled to manage her swings between depression and mania with willpower and denial, but after a period of mania and some risky financial decisions, Castine’s life came crashing down and she lost her home, her life savings, and her grasp on reality. “I was homeless, suicidal, and psychotic,” she says. “That was the point where I realized I needed help.”

Castine was hospitalized, diagnosed with alcoholism and bipolar disorder, and began taking mood-stabilizing medication. “I was ready for treatment,” she says. “I knew that I was sick and I was willing to take the medication.”

Bipolar and Addicted: Getting Help

If you have bipolar disorder and think you may have a problem with drugs or alcohol, says Duckworth, both issues should be addressed together — in fact, he believes that anyone with substance-abuse issues should be screened for bipolar disorder or other mood disorders. Mood-stabilizing medications won’t fix the struggles with addiction, but they may reduce the drive toward it once the mania and depression are addressed.

Jacqueline Castine is living proof of this approach. Although she continues to struggle with managing the ups and down caused by her bipolar disorder, she believes it is now mostly under control. Today, at age 68, Castine has rebuilt her financial life, has written several books about her experiences (including Recovery From Rescuing and I Wish I Could Fix It, But…), and has a career she’s passionate about: She works as a community education specialist to raise awareness of mental-health issues and as a spokesperson for the Depression and Bipolar Support Alliance.

People who have addictive behaviors feel frustrated when they relapse in the recovery stage. With each relapse the feel of frustrated will be highlighted more, to where they believe that cannot be overcome their addiction. The root cause of inability to overcome any addiction is including: false beliefs and irrational exceptions.

One of the false beliefs about recovery that is repeated too much is; “I have decided that I don’t drink alcohol, so, I shouldn’t have a problem!” While the fact that recovery is a process, not an event.

To decide for stopping addictive behavior is the first step, for attending to the end of the path of recovery, you need to more steps. Even an addictive behavior is formed during a long process. People don’t become addicted just one glass of alcohol or one sex. It takes time to master each skill.

The achievement of mastery in addiction recovery as other arts requires weeks and months of hard work on yourself.

Principles of the art of addiction recovery

1. Being specific
2. Stopping the behavior is not enough
3. To leave the comfort zone every day
4. Monitoring the progress of recovery
5. To be aware of your thoughts, emotions, and behaviors
6. Taking each day one step at a timeBeing specific

Everyone has their own path to recovery, because no two people are exactly alike, they have different bodies, beliefs, values, feelings, behaviors, and environments.

Stopping the behavior is not enough

The psychological structure of person who had addictive behavior has high tendency to be addicted again. This structure should be changed so that he/she hasn’t be tendency to addictive behaviors. This change requires passing through the different stages of recovery process.

To leave the comfort zone every day

One of the main obstacles to change is leaving comfort zone, when you leave your comfort zone every day, the passing of comfort zone become an enjoyable habit.

Monitoring the progress of recovery

The recovery monitoring program should be designed so that maintains you in the path of growth. You can modify it to suit any conditions.

To be aware of your thoughts, emotions, and behaviors

To get out of the addiction recovery first happens in the mind. When you have awareness on your thoughts and emotions you can easily and quickly correct any deviation from the path.

Taking each day one step at a time

When you take one step every day and make a small change, not only you keep yourself on the path of recovery, but you overcome resistance to change and any procrastination.
If you follow these principles, be sure that you can be overcome any kind of addictive behavior.

Like this:

Before her death, Amy Winehouse had cycled in and out of rehab. Many celebrities have done the same, with some having more success than others at staying on the wagon. A neuroscientist explains why traditional therapy often seems to fall short of expectations

Singer Amy Winehouse’s fame and infamy have now been forever linked to one word: rehab. She is only one of many recent high-profile cases in which attempts at rehabilitation from substance abuse failed. Amidst strange public outbursts earlier this year, actor Charlie Sheen asserted that it was not rehab, but rather he, himself, that had been his secret weapon against abusingcocaine and booze.

And celebrities are not the only ones with untreated substance abuse problems. More than 20 million Americans ages 12 and older needed—but were not receiving—treatment as of 2007, according to the Substance Abuse and Mental Health Services Administration.

The cause of the 27-year-old singer’s July 23 death is still unknown. Initial autopsy results were inconclusive, and toxicology tests will likely take at least two weeks. But the Grammy Award–winner had a recent history replete with physical health problems, psychological difficulties, and drug and alcohol abuse. In 2007 Winehouse was admitted to the hospital after overdosing on a combination of alcohol, cocaine, ecstasy, heroin and ketamine. She had at least a few stints at in-patient rehabilitation clinics but did not entirely stay clean afterward.

In her 2007 hit “Rehab” Winehouse repeatedly shrugged off the suggestion with the refrain (“They tried to make me go to rehab, but I said, ‘no, no, no,'”) in her dark, bluesy voice. Was she right to be skeptical of this classic treatment? Many of these programs, including 12-step plans such as Alcoholics Anonymous, often embrace at least some aspects of an abstinence-only approach and reliance on a “higher power.” At least one overview of decades of research on AA’s effectiveness suggests it works for many problem drinkers in conjunction with professional help. Nevertheless, the majority of people who enter more formal treatment centers suffer relapses.

Scientific American spoke with Bankole Johnson, a professor of neuroscience at the University of Virginia (U.V.A.) School of Medicine. He is also the editor of the new text Addiction Medicine, and has worked on the development of new pharmacological approaches to treating addiction.

Are there differences in trying to treat alcoholism versus other drug addictions or combinations of addictions?
There’s no general difference. You use the same approach of determining what the patient needs. A lot of addictions do have a pharmacological component. We don’t have a good drug for cocaine addiction, but we have drugs for alcohol addiction, opiate addiction and a wide range of addictions.
How well does traditional rehab work?
I don’t believe that traditional rehabilitation using self-help methods is effective. In fact, the data suggest that they’re not much better than spontaneous rates of recovery. For alcoholism, up to a quarter of people respond on their own, and a lot of recovery centers have rates that are not even that high. So-called rehabilitation centers should publish their rates of improvement, and they should be required by law to do so. Cancer centers do. But rehabs are just this black box.

Is it fair to generalize across different rehabilitation centers and programs? Are they all black boxes or do many of them use similar approaches?
Most rehabs in the United States are based on the Minnesota model. They have a lot of groups, they follow 12-step self-help programs. They tend not to be medication-based.

The myth is that people have to reach rock bottom to get treatment, but that is not the case if they are being provided with evidence-based medicine.

Is there a way to know what sorts of rehab approaches will work best for which people?
Sometimes you can tell by the patient’s profile. Then you can combine what you think are the essentials for what you might need psychologically and medically.

There have been treatment-matching programs. Project MATCH aimed to determine whether different types of psychotherapy would be better. After the study there was not that much difference in the psychotherapies. It might mean that they do work well—and that the dose-effect is very small.

In another study, COMBINE, people received behavioral intervention, cognitive therapy, family therapy—every therapy they could think of. And those patients did worse than a brief intervention and a placebo pill.

Do you see a place for combining newer pharmacological interventions with more traditional therapies?
We use such approaches at U.V.A. I believe that the combination of the two is right for most patients.

Is there a different term that you would use to describe the medication-based approach?
I wouldn’t call it a “rehabilitational” approach. I would use the term evidence-based treatment, which is really what I think is required. The medicines that work are better than the psychological treatment alone. To not have someone have a medicine is like tying your hands behind your back.

Alcoholism is about 60 percent genetic and biological—that’s about the same percent as asthma or high blood pressure. And no one would dream of treating asthma with psychological methods alone. No one would dream of telling someone with high blood pressure to just relax and take it easy. Why then, with alcohol and drug dependence, would that be a reasonable treatment? With diabetes, yes, you can have behavioral control for diabetes—you tell them not to eat too much sugar or not to eat a whole cake, but at the end of the day you still give them insulin.

Is there anything we can learn from the case of Amy Winehouse’s history and death?
Obviously it’s a tragedy for anyone to die of alcohol or drug addiction. There’s a lesson to be learned: People should demand more evidence-based treatment. This should make people think about asking the question: How should we deliver the best treatment?

Does overcoming addiction really depend on a person’s decision and willpower to do so?
It’s a complete myth. And it’s one of the myths that has to be dispelled. One of the presumed tragedies of Amy Winehouse,—if this turns out to be related to drug and alcohol use—is that she didn’t want to go to rehab. But rehab might not have been necessary. Maybe medical treatment from a personal doctor would have been an option.

The key to addiction treatment is that anyone who wants treatment gets effective treatment. And it doesn’t depend on any power—higher power, lower power,willpower. It takes the level of compliance of anyone going to a doctor to get checked out.

When people realize it might be possible to get treatment without superhuman power, maybe it will make people want to seek treatment. It’s a message of hope.